Jack Holevatz, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6525-26 Issued in WI

Practice address

1635 Maple LN
Ashland, WI 54806-3610

Phone

(715) 685-5400

Fax

(715) 685-5102

NPI assigned

Jul 29, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Medical Center Inc

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Medicare reassignment NPD
• Memorial Medical Center Inc

  • Rural Health Clinic/Center
  • Ashland, WI
  • NPI 1770255937
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1750935771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-5400",
            "fax_number": "715-685-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEVATZ",
        "first_name": "JACK",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6525-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Heinz
• Jennifer Bast Helenius, COTA
• Hickman Chiropractic, LLC
• Patrick Alan Hickman, DC
• Theresa M Hintze, PSYD, LPC
• Courtney Holloway
• William J Holzhaeuser, AUD
• Home Medical Products and Services, LLC
• Noel Hong, R.PH.
• Alexa M Honstad, CRNA

• Occupational Therapist in Ashland, WI
• Providers in Ashland, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.